In contrast with paraphernalia laws, prescription laws do prohibit the sale, distribution, and possession of hypodermic syringes or needless without a valid medical prescription regardless of knowledge of intended use. Prescription laws are in effect in nine states (see Figure 5.1), the District of Columbia (Valleroy et al., in press), and Puerto Rico. (The nine states are California, Delaware, Illinois, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, and Rhode Island.) In those jurisdictions, it is a criminal offense to sell or possess syringes or needles without a valid medical prescription. Connecticut and Maine have recently modified their prescription laws to allow syringes and needles to be sold over the counter. Typical prescription statutes also attempt to set certain limitations on the physician's discretion to dispense such valid prescriptions. That is, not only do these statutes require a valid medical prescription, but they also place some legal constraints on physicians by requiring that prescriptions be issued only in cases with a legitimate medical purpose (Gostin, 1993). As depicted in Figure 5.1, all states with prescription laws also have paraphernalia laws, and only five states (i.e., Alaska, Connecticut, Iowa, North Dakota, and South Carolina) have laws permitting both the purchase and the possession of syringes without a medical prescription.

Judicial Rulings
Constitutionality

In examining legislation pertaining to the regulation of drug paraphernalia, an important consideration is the recognized broad authority of the states to regulate the manufacture, sale, prescription, and use of drugs by exercising their police powers. The constitutionality of this broad authority has been acknowledged by the Supreme Court as far back as 1921 (Minnesota ex re. Whipple v. Martinson, 256 U.S. 41) and was reiterated by the Court in more recent cases (Robinson v. State of California, 1962). Moreover, in subsequent years, unsuccessful challenges to the authority of state and local laws to regulate drug paraphernalia (in contrast to drug use itself) have been made (Wheeler v. United States, 276 A.2d 722, D.C.1971; Village of Hoffman Estates v. Flipside, Hoffman Estates, Inc., 455 U.S. 489, reh'g denied, 456 U.S. 950, 1982). In these cases, the Supreme Court has made it clear that state and local government authority to enact laws aimed at controlling drug use also extends to their authority to control the instruments of drug use. Thus, state and local government authority to restrict individuals from manufacturing, selling, or using drug paraphernalia appears to be on firm constitutional footing.

The prescription laws have also withstood constitutional challenges (People v. Bellfield, 33 Misc. 2d 712, 230 N.Y.S.2d 79 [1961], aff'd, 11 N.Y.2d



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